The American Medical Association (AMA) salutes Congress for passing telehealth provisions in the omnibus spending bill that promise a new era of access for patients across the country.

“Congress has taken a crucial step in starting a revolution in patient access. The AMA aims to continue being a partner in moving it forward,” said AMA President Gerald E. Harmon, M.D. “The dramatic increase in adoption of telehealth that occurred in 2020 has allowed medical care that combines in-person and virtual services to become the new standard of care. This new legislation guarantees that patients with Medicare will continue to benefit from this important innovation in health care delivery.”

In the omnibus, Congress extended telehealth policies adopted during the pandemic. That extension is for five months after the public health emergency is no longer in effect. Patients will benefit from extending these telehealth policies, and Congress should make them permanent in the coming year.

Omnibus provisions:

• In a victory for access, Medicare patients can receive telehealth services regardless of where they live. Before the pandemic, Medicare patients needed to be physically located in a rural area to access telehealth services, shutting out urban and suburban patients from receiving the same benefits of virtual care. In addition, patients will continue to receive virtual care wherever they can access a telecommunications system, including the home. Before the pandemic, rural patients needed to travel to an “originating site,” essentially another health care facility, outside of their home to access telehealth services.  Enactment of the CARES Act in 2020 gave Centers for Medicare & Medicaid Services (CMS) the authority to waive the geographic and originating site restrictions, which CMS subsequently did through the end of the public health emergency.   
• It delays the in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology. Last year’s omnibus removed the geographic restrictions and added the home of the beneficiary as a permissible originating site for telehealth services when used for the purposes of diagnosis, evaluation, or treatment of a mental health disorder, effective for services furnished after the end of the public health emergency.   

• Finally, the omnibus allows for audio-only telehealth only services (e.g., delivered by phone) to continue to be provided to Medicare telehealth patients. Telehealth is typically defined as two-way audio-visual technology. Yet, many patients, particularly those in rural and underserved communities, lack the two-way audio-visual technology. Permitting audio-only telehealth services will help preserve patient access to physicians beyond the end of the current public health emergency. 

“For decades, the AMA has recommended permanently removing the geographic and originating-site restrictions. Likewise, the AMA pushed to preserve the existing telehealth flexibilities since the COVID pandemic swept the country. It’s refreshing to see Congress agree. As patients take advantage of these changes and health access is broadened, we are hopeful that Congress will see the wisdom of making these changes permanent,” Dr. Harmon said.